[Prevention of incompetence of sigmoidorectal anastomosis after anterior resection of the rectum in cancer]. / Profilaktika nesostoiatel'nosti sigmorektal'nykh anastomozov posle perednei rezektsii priamoi kishki po povodu raka.

The results of surgery in 11 patients with rectal cancer are analysed. The anterior rectal resection was performed in all cases, in 38 cases-the lower resection was performed. The use of decompressive colostomy as a method to prevent complications, caused by anastomotic incompetence is recommended. The colostomy was used in 51.3% cases. Besides colostomy, in 27 (26.2%) patients the antiseptic connection elements impregnated with kanamycin, dioxidine and cephamezine were used to prevent sigmoido-rectal anastomotic incompetence. The rate of anastomotic incompetence was 12.6% (14 patients). There were no mortality. The use of decompressive colostomy in operations on transverse colon especially in cases of lower rectal resection and in patients with partial colon ileus is advocated. The use of antiseptic connective elements is an efficient method to prevent anastomotic incompetence.

[Prevention of incompetence of sigmoid-rectal anastomosis after frontal resection of rectum in the treatment of cancer]. / Profilaktika nesostoiatelnosti sigmorektalnykh anastomozov posle perednei rezektsii priamoi kishki pri rake.

Planned anterior resection of the rectum for carcinoma was conducted in 111 patients, 38 of them underwent low resection. The formation of relieving transversostomy is suggested as a method for the prevention of early postoperative complications resulting from incompetence of the anastomosis. It was formed in 51.3% of cases. Besides, for preventing incompetence of sigmoidorectal anastomoses, connecting antimicrobial elements with kanmycin, dioxydin, and cephamezin were applied in 27 patients (26.2%). Incompetence of the anastomosis was not encountered in such cases. Complications occurred in the immediate postoperative period in 45 patients (40.5%), 14 of them (12.6%) had incompetence of the anastomosis suture. There were no fatal outcomes. The authors believe relieving transversostomy to be expedient mainly in low resection of the rectum and in patients with partial obstruction of the large intestine.

[Surgical tactics in acute obturation obstruction of the large intestine of tumor etiology]. / Khirurgicheskaia taktika pri ostroi obturatsionnoi tolstokishechnoi neprokhodimosti opukholevoi étiologii.

The article deals with the results of treatment of 300 patients with acute obstruction of the colon of neoplastic etiology. Patients over 60 years of age accounted for 69.7% of cases. Among 300 patients 211 were subjected to emergency operation. The total mortality was 31.3%. Peritonitis was found during the operation in 81.7% of patients, perforation of the colon was revealed in 53 of them. Stage IV carcinoma was found in 74 patients. The authors point out that late operations lead to poorer outcomes of the disease and suggest performing the surgical intervention no later than 6 hours after hospitalization. The expediency of two-stage (mortality rate 17.0%) and three-stage (mortality rate 17.9%) operations is noted because their results are better than those of a radical one-stage operation (mortality rate 46.1%).

[Abdominoanal resection of the rectum with a lowering of different sections of the left half of the colon]. / Briushno-anal'naia rezektsiia priamoi kishki s nizvedeniem razlichnykh otdelov levoi poloviny obodochnoi kishki

In tumor localization at the level of 7--12 cm aside from the anus the authors performed 168 abdominoanal resections of the rectum with descending of different portions of the left colon. Among these patients in 126 subjects descending of the sigmoid in the anal canal was performed, in 30 of the splenic angle of the transverse colon, and in 12 of a proximal portion of the descending left colon. Some characteristic features of surgery for descending of different portions of the left colon are described.